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A modified dosage schedule for increased efficiency in PUVA treatment of psoriasis
Author(s) -
CARABOTT F. M.,
HAWK J. L. M.
Publication year - 1989
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/j.1365-2230.1989.tb02579.x
Subject(s) - medicine , clearance , psoriasis , cumulative dose , adverse effect , puva therapy , dosing , dermatology , plaque psoriasis , surgery , urology
Summary Ten patients with chronic widespread plaque psoriasis, all of whom had previously completely cleared and suffered a suhsequent widespread relapse after conventional PUVA therapy, were treated with a modified UVA dosage schedule, with psoralen formulation and dosage unchanged. Initial and incremental UVA doses were maximized to near‐erythemogenic levels as determined hy weekly testing for minimal phototoxic dose (MPD), treatment heing given three times a week. A comparison of complete psoriasis clearing hetween the modified treatment and the last PUVA course showed a geometric mean reduction in treatment duration of 55% (P < 0001) for a similar numher of treatments each week, and a cumulative UVA dose of 31% (P<0 05), representing a reduction in treatment duration from 9‐1 to 4‐1 weeks and cumulative UVA dose reduction of 100‐8 to 69‐9 J/cm 2 . Such an improvement in efficiency permits a marked increase in treated patient numhers for the same cost, and s i more convenient. The reduction in the total cumulative UVA dose given as larger individual doses also seems likely to lead to a lower incidence of cutaneous long‐term, especially carcinogenic, adverse effects.